Second Dose: 4-6 years of age (may be given earlier, if at least 28 days after the 1st dose)

Some infants younger than 12 months should get a dose of MMR if they are traveling out of the country. (This dose will not count toward their routine series.)

Some adults should also get MMR vaccine: Generally, anyone 18 years of age or older who was born after 1956 should get at least one dose of MMR vaccine, unless they can show that they have either been vaccinated or had all three diseases.

Children between 1 and 12 years of age can get a “combination” vaccine called MMRV, which contains both MMR and varicella (chickenpox) vaccines.

Some people should not get MMR vaccine or should wait.

Anyone who has ever had a life-threatening allergic reaction to the antibiotic neomycin, or any other component of MMR vaccine, should not get the vaccine. Tell your doctor if you have any severe allergies.

Anyone who had a life-threatening allergic reaction to a previous dose of MMR or MMRV vaccine should not get another dose.

Some people who are sick at the time the shot is scheduled may be advised to wait until they recover before getting MMR vaccine.

Pregnant women should not get MMR vaccine. Pregnant women who need the vaccine should wait until after giving birth. Women should avoid getting pregnant for 4 weeks after vaccination with MMR vaccine.

Any of these might be a reason to not get the vaccine, or delay vaccination until later.

What are the risks from MMR vaccine?

A vaccine, like any medicine, is capable of causing serious problems, such as severe allergic reactions.

The risk of MMR vaccine causing serious harm, or death, is extremely small.

Getting MMR vaccine is much safer than getting measles, mumps or rubella.

Most people who get MMR vaccine do not have any serious problems with it.

Mild Problems

Fever (up to 1 person out of 6)

Mild rash (about 1 person out of 20)

Swelling of glands in the cheeks or neck (about 1 person out of 75)

If these problems occur, it is usually within 6-14 days after the shot. They occur less often after the second dose.

Moderate Problems

Seizure (jerking or staring) caused by fever (about 1 out of 3,000 doses)

Temporary pain and stiffness in the joints, mostly in teenage or adult women (up to 1 out of 4)

Temporary low platelet count, which can cause a bleeding disorder (about 1 out of 30,000 doses)

Severe Problems (Very Rare)

Serious allergic reaction (less than 1 out of a million doses)

Several other severe problems have been reported after a child gets MMR vaccine, including:

Deafnes

Long-term seizures, coma, or lowered consciousness

Permanent brain damage

These are so rare that it is hard to tell whether they are caused by the vaccine.

What if there is a serious reaction?

What should I look for?

Any unusual condition, such as a high fever or unusual behavior. Signs of a serious allergic reaction can include difficulty breathing, hoarseness or wheezing, hives, paleness, weakness, a fast heart beat or dizziness.

What should I do?

Call a doctor, or get the person to a doctor right away.

Tell your doctor what happened, the date and time it happened, and when the vaccination was given.

Ask your doctor to report the reaction by filing a Vaccine Adverse Event Reporting System (VAERS) form. Or you can file this report through the VAERS website at www.vaers.hhs.gov, or by calling 1-800-822-7967.

VAERS does not provide medical advice.

The National Vaccine Injury Compensation Program

The National Vaccine Injury Compensation Program (VICP) was created in 1986.

Persons who believe they may have been injured by a vaccine can learn about the program and about filing a claim by calling 1-800-338-2382 or visiting the VICP website at www.hrsa.gov/vaccinecompensation.

U.S. Department of Health ＆ Human Services Centers for Disease Control and Prevention: Vaccine Information Statement

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Where We Stand: Folic Acid01-19-2015

In an effort to reduce the prevalence of spina bifida, the American Academy of Pediatrics (AAP) endorses the recommendation of the US Public Health Service that all women capable of becoming pregnant consume 400 micrograms (mcg) per day of folic acid (a B vitamin).

Help Prevent Neural Tube Defects

Folic acid helps to prevent neural tube defects (NTD), which include spina bifida. Although some foods are fortified with folic acid, it is not possible for women to meet the 400 mcg goal through a typical diet. Thus, the AAP policy statement recommends a daily multivitamin tablet that contains folic acid in the recommended dose. Studies show that if all women of childbearing age met these dietary requirements, 50 percent or more of NTDs could be prevented.

Talk with Your Doctor about Folic Acid

Women who are at high risk for an NTD-affected pregnancy (for example because of a previous NTD-affected pregnancy, having diabetes mellitus, or taking antiseizure medications) are advised to discuss their risk with their doctor. This includes possible treatments with very high doses of folic acid (4,000 mcg per day), beginning one month before becoming pregnant and continuing throughout the first trimester. As the doctor will explain, however, women should not attempt to achieve this very high dose of folic acid by taking multivitamin supplements, but rather only under the care of a physician.

The Story of Folic Acid Fortification (CDC) – Short video that chronicles the hard work behind folic acid fortification in the United States and its positive effects on the health and well-being of so many children and families.

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Winter Safety Tips01-12-2015

Whether winter brings severe storms, light dustings or just cold temperatures, the American Academy of Pediatrics (AAP) has some valuable tips on how to keep your children safe and warm.

What to Wear

Dress infants and children warmly for outdoor activities. Several thin layers will keep them dry and warm. Don’t forget warm boots, gloves or mittens, and a hat.

The rule of thumb for older babies and young children is to dress them in one more layer of clothing than an adult would wear in the same conditions.

If a blanket must be used to keep a sleeping infant warm, it should be tucked in around the crib mattress, reaching only as far as the baby’s chest, so the infant's face is less likely to become covered by bedding materials.

Hypothermia

Hypothermia develops when a child's temperature falls below normal due to exposure to colder temperatures. It often happens when a youngster is playing outdoors in extremely cold weather without wearing proper clothing or when clothes get wet. It can occur more quickly in children than in adults.

As hypothermia sets in, the child may shiver and become lethargic and clumsy. Speech may become slurred and body temperature will decline in more severe cases.

If you suspect your child is hypothermic, call 911 at once. Until help arrives, take the child indoors, remove any wet clothing, and wrap him in blankets or warm clothes.

Frostbite

Frostbite happens when the skin and outer tissues become frozen. This condition tends to happen on extremities like the fingers, toes, ears and nose. They may become pale, gray and blistered. At the same time, the child may complain that his/her skin burns or has become numb.

If frostbite occurs, bring the child indoors and place the frostbitten parts of her body in warm (not hot) water. 104° Fahrenheit (about the temperature of most hot tubs) is recommended. Warm washcloths may be applied to frostbitten nose, ears and lips.

Do not rub the frozen areas.

After a few minutes, dry and cover the child with clothing or blankets. Give him/her something warm to drink.

If the numbness continues for more than a few minutes, call your doctor.

Winter Health

If your child suffers from winter nosebleeds, try using a cold air humidifier in the child's room at night. Saline nose drops or petrolatum may help keep nasal tissues moist. If bleeding is severe or recurrent, consult your pediatrician.

Many pediatricians feel that bathing two or three times a week is enough for an infant’s first year. More frequent baths may dry out the skin, especially during the winter.

Cold weather does not cause colds or flu. But the viruses that cause colds and flu tend to be more common in the winter, when children are in school and are in closer contact with each other. Frequent hand washing and teaching your child to sneeze or cough into the bend of her elbow may help reduce the spread of colds and flu.

Children 6 months of age and up should get the influenza vaccine to reduce their risk of catching the flu.

Winter Sports and Activities

Set reasonable time limits on outdoor play to prevent hypothermia and frostbite. Have children come inside periodically to warm up.

Using alcohol or drugs before any winter activity, like snowmobiling or skiing, is dangerous and should not be permitted in any situation.

Ice Skating

Allow children to skate only on approved surfaces. Check for signs posted by local police or recreation departments, or call your local police department to find out which areas have been approved.

Advise your child to:

Skate in the same direction as the crowd

Avoid darting across the ice

Never skate alone

Not chew gum or eat candy while skating.

Consider having your child wear a helmet, knee and elbow pads, especially while learning to skate.

Sledding feet first or sitting up, instead of lying down head-first, may prevent head injuries.

Consider having your child wear a helmet while sledding.

Use steerable sleds, not snow disks or inner tubes.

Sleds should be structurally sound and free of sharp edges and splinters, and the steering mechanism should be well lubricated.

Sled slopes should be free of obstructions like trees or fences, be covered in snow not ice, not be too steep (slope of less than 30º), and end with a flat runoff.

Avoid sledding in crowded areas.

Snow Skiing and Snowboarding

Children should be taught to ski or snowboard by a qualified instructor in a program designed for children.

Never ski or snowboard alone.

Young children should always be supervised by an adult. Older children’s need for adult supervision depends on their maturity and skill. If older children are not with an adult, they should always at least be accompanied by a friend.

All skiers and snowboarders should wear helmets. Ski facilities should require helmet use, but if they do not, parents should enforce the requirement for their children.

Equipment should fit the child. Skiers should wear safety bindings that are adjusted at least every year. Snowboarders should wear gloves with built-in wrist guards. Eye protection or goggles should also be used.

Slopes should fit the ability and experience of the skier or snowboarder. Avoid crowded slopes.

Avoid skiing in areas with trees and other obstacles.

Snowmobiling

The AAP recommends that children under age 16 not operate snowmobiles and that children under age 6 never ride on snowmobiles.

Do not use a snowmobile to pull a sled or skiers.

Wear goggles and a safety helmet approved for use on motorized vehicles like motorcycles.